Between the years 1996 to 1998 and 2009 to 2011, the number of persons in the population reporting a spine condition rose from 27.4 million to 31.0 million, but the proportion of total population with a spine condition (10.1%) remained the same in both time periods. However, the distribution of the population with a spine condition, by age group, showed a consistent shift upward as the population ages, reflecting the overall aging of the US population. (Reference Table 10.1 PDF [1] CSV [2])
Health care treatments and visits contribute to the burden of spine conditions. Ambulatory physician visits, home health care visits, and hospital discharges all rose by 17%, 9%, and 13%, respectively, between the years 1996 to 1998 and 2009 to 2011. While still accounting for a relatively small number of visits, ambulatory nonphysician care visits rose from 101 million in the earlier time frame to 183 million in the most recent years, an increase of 83%. However, prescription medications for spine conditions show the most dramatic rise, jumping from 353 million prescriptions to 680 million over the two time frames, an increase of 93%. (Reference Table 10.2 PDF [3] CSV [4])
Overall, ambulatory care visits accounted for the largest share of per-person direct cost for persons with a spine condition. At an average cost of $3,077 per-person between 2009 and 2011, an increase of 81% from 1996 to 1998, ambulatory care accounted for 38% of per person direct cost between 2009 and 2011. While the share of mean per-person cost for inpatient care dropped from 36% to 28% between 1996 and 1998 and 2009 to 2011, the mean cost rose from $1,755 to $2,267, an increase of 29%. At the same time, the average per-person cost for prescriptions rose from $650 to $1,736, in 2011 dollars, an increase of 167%. (Reference Table 10.4 PDF [5] CSV [6])
Total direct per-person health care costs for persons with a spine condition were $8,150, and increase of 69% since 1996 to 1998. Incremental direct per-person costs, those costs most likely attributable to a spine condition, rose from $934 to $1,496, in 2011 dollars, an increase of 60%. (Reference Table 10.6 PDF [7] CSV [8])
Total aggregate direct costs for persons with a spine condition were $253 billion in 2009 to 2011, a rise of 91% from the $132.4 billion in 1996 to 1998, in 2011 dollars. Incremental aggregate direct costs increased from $25.6 billion in 1996 to 1998 to $46.4 billion in 2009 to 2011, an increase of 82%.
Indirect costs associated with lost wages for persons ages 18 to 64 years are not calculated for persons with a spine condition However, back pain is often cited as the reason for bed days and lost work days by persons in the labor force. In 2012, 3.6 million persons in the prime working ages of 18 to 64 years reported they were unable to work at the time due to chronic back or neck problems, with another 1.7 million reporting they were limited in the kind or amount of work they can do as a result of chronic back or neck pain. (Reference Table 2.10.2 PDF [9] CSV [10])
Also, in 2012, 14.2% of the workforce age population reported an average of 7.6 bed days in the previous 12 months, for a total of 170.7 million bed days, due to chronic back or neck pain. In addition, 16.1% of this same population reported an average of 11.4 lost work days in the previous year due to chronic back or neck pain, or more than 290 million work days lost in 2011/2012 due to back pain. (Reference Table 2.11.1 PDF [11] CSV [12])
Links:
[1] https://www.boneandjointburden.org/docs/T10001.1.pdf
[2] https://www.boneandjointburden.org/docs/T10001.1.csv
[3] https://www.boneandjointburden.org/docs/T10003.2.pdf
[4] https://www.boneandjointburden.org/docs/T10003.2.csv
[5] https://www.boneandjointburden.org/docs/T10005.4.pdf
[6] https://www.boneandjointburden.org/docs/T10005.4.csv
[7] https://www.boneandjointburden.org/docs/T10007.6.pdf
[8] https://www.boneandjointburden.org/docs/T10007.6.csv
[9] https://www.boneandjointburden.org/docs/T2.10.2.pdf
[10] https://www.boneandjointburden.org/docs/T2.10.2.csv
[11] https://www.boneandjointburden.org/docs/T2.11.1.pdf
[12] https://www.boneandjointburden.org/docs/T2.11.1.csv